14-104155 • • % Electrical
Community&Federal eWaservices Permit #: 14-104155-00-EL
s 33325 8th Ave S
Federal Way,WA 98003
Inspection Request Line: 253 035-3050
FILE
Ph:(253)835-2607 fax:(253)835-2809 p Q
Project Name: LAKOTA SEWAGE TREATMENT
Project Address: 3203 SW DASH POINT RD Parcel Number: 122103 9105
Project Description: Installation of new PLC and controls for polymer system.
Z
Owner Applicant Contractor
LAKEHAVEN UTILITY DISTRICT LAKEHAVEN UTILITY DISTRICT OWNER IS CONTRACTOR
PO BOX 4249 PO BOX 4249
FEDERAL WAY WA 98063 FEDERAL WAY WA 98063
Additional Permit information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 1
PERMIT EXPIRES Tuesday, February 10, 2015
Permit Issued on Thursday,August 14, 2014
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and th- ity of Federal Way. ,/'
Owner or agen .-/-f� Date: --/�"4
4 .
1
A 44 41
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THIS CARD IS TO RE ON-SITE
OF 4A
CITY
Construction Inspation Record
Federal Way INSPECTION REQ TS: (253)835-3050
PERMIT#: 14-104155-00-EL Address: 3203 SW DASH POINT RD
Project: LAKEHAVEN UTILITY DISTRICT FEDERAL WAY, WA 98023-2340
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
o be covered until it is approved. Check with your
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not e pp Y
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
LIFER Ground(4295) U Ditch cover(4030) Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
• . • •
•
Pool Bonding(4195) �
O 0 Temporary Power(4275) Service(4235)
Approved Approved Approved
By Date By Date By Date
Feeders/Sub-panels(4045) `. •
0 Rough Electrical(4225) 0 Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
•
El Final-Electrical(4055)
Approved
1ike.---- Date2 _4tb
r
0 Rough Electrical Final Electrical Right of Way
Approved Approved Approved
By Date By Date By Date
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_' AUGZ ELECTRICAL
¢ Z014
Federal Way C�NOFFFDERAL PERMIT APPLICATION
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PERMIT NUMBER /9_ C O vy.�s - .�
SUITE/UNIT/SPACE S
SITE ADDRESS: 0•- S Lc) 0c, Sc � cUl A-
PROJECT VALUATION ASSESSOR'S TAX//PARCEL P CURRENT/PROPOSED USE
$ 75 006. Ord f a- 01-- / o3 _ `� l O S-
PROJE�T NAME 1-'040411_ P L tit p a � P�
(Tenant or Homeowner Last Name) � f V'
C,.g. cL V\.e� Pr--C- .AP _co Cs.
PROJECT DESCRIPTION ' ' \cS "\'P 0- �4ev�'�r
Detailed description of work to
be included on this permit only
AIdE \ , PRIMARY PHONE
PROPERTY OWNER Y\_L1c.- *A- U A-.l ( ` 0'kc i-(..1.53)94(- lsre
Vc-43. 1Cok 4,R kg.
ITT r STATE ZIP FAX
Ce ti k Ctrl 75266 3 ( )
NAME PRIMARY PHONE
L-CkVLI OA".k tVik 4 Elk"tr-1- x)94( - f fen
MAkING ELECTRICAL 6 DtiC ik. AV`7
CONTRACTOR CITY ��(}`y� STATE ZIP FAX
WA CONTRACTOR'S LICENSE B ��EXpIRATION ATE FEDERAL WAY BUSINESS LICENSE I
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p� " PRIMARY PHONE
APPLICANT �CXv` -k vim �cx.t.A,C _ Z0)4Oc-aeof
MAILING
TY STATE ZIP FAX a,,y�,:,
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B PRIMARY PHONE
PROJECT CONTACT V "`. R S�) S-f 6 Za I
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application. r
�� �� DATE r-i""f
SIGNATURE: i
PRINT NAME: 1I& a . a P t AAA: • ,A
Bulletin#160-January 1,2013 Page 1 of 2 101-Iandouts\Electrical Permit Application